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Physician, author, and health care reform advocate David K. Cundiff discusses his article “Accountable care cooperatives: a 2026 vision for U.S. health care.” David analyzes the severe funding crisis affecting American families …
Community cooperatives offer a solution to the affordable health care crisis [PODCAST]
If you want to understand what “profits before patients” means in American health care, don’t start with a spreadsheet. Start with a story.
During residency, I cared for a middle-aged mother of two who came to our community hospital emergency room struggling to breathe. It didn’t take long to realize she needed something we couldn’t offer: urgent heart surgery at a larger hospital.
After a 30-hour shift, I filed the transfer request …
Profits before patients: the hidden cost of U.S. health care
It is said that we live in difficult times, and that reality is unavoidable for anyone who does not live as a hermit in a cave somewhere. For patients and their doctors, the signs of impending failure are equally unavoidable.
Health care consumes 18 percent of U.S. gross domestic product and continues to rise faster than the rate of inflation. Consumer confidence in the goodwill and scientific integrity of U.S. health …
Military leadership lessons for the U.S. health care crisis
Health care is rapidly transitioning toward value-based care, yet many clinicians remain uncertain about what it actually means for their daily work. Despite widespread discussion of quality metrics, cost containment, and population health, clinicians are increasingly expected to deliver system-level outcomes without structured preparation to function within the systems that demand them.
If health care seeks to improve the lives of clinicians and patients while strengthening continuity of care, it must …
Value-based care workforce: Bridging the gap in clinical education
American health care has changed so profoundly in the last three to four decades that it is all but unrecognizable to those of us spending our careers in private practice. In my opinion, the root causes are not that complex. Foremost among them is the unconscionable disparity between the remuneration received by hospital-employed physicians and that of their counterparts in private practice for the same service or procedure.
This is abetted …
The death of private practice: unequal pay and hospital power
The veil of pretense was snatched long ago. So, politicians dare not brazenly declare that the U.S. has the greatest health care in the world. The system is broken. Neither Republicans nor Democrats have a remedy. It is a perverted Robin Hood system, where the rich are robbed to serve the poor poorly.
The exorbitant insurance premiums are unaffordable for many, and for others, it is as if it were a …
Curing U.S. health care: Why a fair health tax is the answer
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Vascular surgeon Paula Muto discusses her article “Give the health care dollar back to patients.” Paula argues that the government shutdown over health care funding misses the real issue of administrative bloat …
Bureaucracy now consumes most of your health care spending [PODCAST]
Between 2005 and the present, 195 rural hospitals have closed, with a 50-hospital net reduction occurring just between 2017 and 2023. These closures, compounded by significantly worse measures of social determinants of health (SDOH), high prevalence of Medicaid or Medicare patients, and longer commute times, have created a crisis of access for rural Americans.
The disproportionate impact on rural residents
Compared to their urban and suburban counterparts, …
Rural health care crisis: Can telemedicine close the gap?
Single-payer health care is generally defended with “heart-wrenching” virtue signaling divorced from any cost, economic, or financial reality. The idea that any scarce service or commodity is a right and therefore should be free is fanciful, but impossible. With an indebtedness of $38 trillion and growing, adding greater than $40 trillion as estimated for the cost of “Medicare for All” would absolutely drive the country into insolvency. Even without single-payer, …
Single-payer health care vs. market-based solutions: an economic reality check
Every day, millions of Americans take medications to manage chronic conditions or prevent disease. Prescription drugs are vital tools in modern medicine, but in some circumstances, they can also lead to serious adverse drug interactions, diminished quality of life, and even life-threatening complications.
This is a complex issue with high stakes for patients. Older adults, in particular, are often prescribed multiple drugs by different doctors for different reasons. The Centers for …
Deprescribing in health care: Why less medication can be more
Value-based care represents one of health care’s most important transformations, driving hospitals and health systems to focus on outcomes that truly matter. To succeed in this model, organizations must track and improve their performance metrics continuously, making data health care’s most valuable currency. It is the foundation for improving patient care, reducing complications, and optimizing resource allocation. Yet despite the growing volume of performance metrics being collected, a critical gap …
Value-based care data gap: Why metrics fail to reach the bedside
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Physician, author, and health care reform advocate David K. Cundiff discusses his article “Accountable care cooperatives: a community-owned health care fix.” David outlines a transformative plan to replace the fragmented U.S. insurance …
Community ownership transforms the broken health care system [PODCAST]
The moment the text message lit up my watch, I knew my life had irrevocably changed. I looked down at the miniature screen and found that I could not look away from the gray bubble and the three words that shattered my world: My aunt had passed away. An all-consuming grief overtook me as I processed a reality where my aunt’s boisterous laugh no longer echoed off the walls, along …
Flexible health care funding: Moving beyond disease eradication
“Do no harm.” Upon entering medical school, my classmates and I uttered these words with pride and joy, unaware of the deeper meaning behind them. While it may sound cliché, many of us choose to become doctors because we have a strong desire to help others in some capacity. The esteemed title M.D. fortunately allows us to wear many different hats in serving our communities. Medical doctors have expanded their …
Immigration policy and child health: a medical student’s perspective
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Board-certified internist with a long-standing focus on public health, tobacco control, and preventive care Edward Anselm discusses his article “The economic case for investing in tobacco cessation.” Edward reveals that while smoking …
Tobacco cessation offers untapped revenue for medical practices [PODCAST]
In his recent executive order, Ending Crime and Disorder on America’s Streets, President Trump directed federal agencies to utilize forced institutionalization of unhoused individuals under the guise of public safety, lambasting evidence-based harm reduction programs in the process. Unhoused people are framed as threats by Trump, engaging in open-air drug use and vagrancy. In response, the National Homelessness Law Center condemned this executive order and projected even worse outcomes due …
Executive order on homelessness: Why forced treatment fails
Every night I spend at home, I wake up to the sound of Für Elise by Ludwig van Beethoven. If you asked my dad, who works remotely, he would grimace and tell you he hears it at least 10 times a day. It’s a classic piano piece, don’t get me wrong, but we don’t have a piano, nor are we a family of Beethoven fanatics. My dad probably loved Beethoven …
Immigrant caregiver burden: the hidden cost of the five-year Medicaid wait
The health insurance crisis has finally entered the public consciousness. 200,000 to 350,000 Kentuckians are expected to lose their coverage as a result of the “One Big Beautiful Bill Act.” Commercial insurance carriers have already substantially increased premiums in response to market uncertainty.
Meanwhile, Congress failed to act before the end of the year to extend the expiring enhanced premium tax credits that help millions of Americans afford health insurance …
The health insurance crisis 2026: What Kentuckians need to know
Health insurers have failed in their promise to deliver quality and value to the taxpayers, providers, employers, and their subscribers.
If you find a wasteful government program, isn’t there an obligation to foster a public discussion about it? Physicians for a National Health Plan (PNHP) has developed an analysis that reveals the waste in allowing private health plans to manage Medicaid medical services. According to PNHP, returning management of medical services …
Health insurance waste: Why eliminating the middleman saves billions
During my pediatrics rotation in my third year of medical school, the most important skill I learned was how to listen more carefully.
Children rarely have the language or power to fully articulate their needs. They are forced to rely on adults, systems, and institutions to advocate on their behalf. In pediatrics, that responsibility is not an abstract idea. It shows up in exam rooms where parents must choose to pay …
Why AAP funding cuts threaten the future of pediatric health care
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